Unofficial transcriptions of all intersex relevant questions and
answers plus minutes of other related items are collected
below.

Summary

It's a shame how the responsible NZ Delegation member, paediatrician (!!) Dr
Patrick Tuohy, consistently and blanketly denied the ongoing
IGM practices in NZ, and every time tried to shift the
discussion to trans issues instead ("surgical gender
assignment"). Unfortunately, this was helped by somewhat unhelpful
wording in some NZ reports and by the Committee, using the euphemism
"normalising surgery" instead of the usual descriptive UN language
"involuntary non-urgent treatment" or "non-consensual unnecessary
treatment". Luckily, intersex advocates profited from the NZ NHRIs
delegation present in Geneva (particularly the NZ Human Rights
Commission) also intervening with the Committee to set the record straight and
to ensure a follow-up question. Reagrding the mindset of the NZ
delegation informing their flat-out denials, a few words with Dr Tuohy
after the 3rd Session proved insightful (see minutes below).

15:48h: Harmful practices! CRC expert and
Vice-Chairperson Ms. Amal Salman Aldoseri (Bahrain) is asking
about intitiatives to legally prohibit unnecessary surgeries on
intersex children, as well as regarding social support
services available for intersex children and families, and
education programs on intersex! YAY!!!Unofficial Transcription:

« On harmful practices, I have a question on intersex.
What efforts are put together to legally prohibit the practice of genital
normalisation surgery on intersex children, until they reach an age, where they
can give their view on an informed consent, and what social support services
and accompanying financial allocations are made available to intersex children
and their families? And what educational programs are available for intersex
children and their families, as well [as] for other children on intersexuality?
»

17:26h: Answer on intersex children by NZ
Delegate Dr Patrick Tuohy (Paediatrician, Chief Adviser,
Ministry of Health, Wellington, NZ), admits no legally binding
protections to prevent involuntary surgeries are in place, and at the
present there are also no plans to introduce any, refers to
overview of Medical Council instead ... Mentions
multidisciplinary network of endocrinologists and surgeons,
claims all parents are given access to peer support, mentions the figure of
30 intersex children born annually ... Claims no IGM
practices having taken place since 2006! Consistently tries to
deflect to "gender reassignment" instead –
pinkwashing as per usual Unofficial
Transcription:

Anne Tolley (Head of Delegation and Minister for Social
Development): « I'd like Pat Tuohy to address the question
around education programs available for intersex children and their families.
»

Dr Patrick Tuohy (Paediatrician, Chief Adviser, Ministry of
Health, Wellington, NZ): « In respect to intersex. There
was a question with three parts. The first was, do we have a legally
binding system to prevent genital normalization on children? The
answer is that we do not currently have a legislative framework for this, and
there is no plans in place for that at the present
time.

However, all New Zealand citizens are covered by the health and
disability bill of rights, and all medical practitioners work under the
authority of the Medical Council of New Zealand.

We have a multidisciplinary network of surgeons and
endocrinologists who discuss all cases related to gender whether the
[undiscernible] practices conservative treatment, which is effectively no
gender reassignment, surgical gender reassignment.

We have around 30, between maybe 20 to 30 children a
year. The network of surgeons and endocrinologists is confident that
no medical practitioners are practicing outside of the group.

The information from hospital coding records show that no
surgery has taken place in New Zealand related to gender reassignment
from the time 2006.

In social support services to intersex children and their families the
parents are given a chance from within the commissions involved in that network
to talk to other parents and family members of children with intersex
conditions and the entire family is offered peer
support.

I’m not aware if we have any specific educational
programs for intersex children in a formal sense, apart from that
informal network that is available and I don’t know whether we have anything in
the education realm for that, I think not, and we could, I’d come back with
some further information tomorrow if that was required.
»

10:01h: The session continues. Beforehand, I was able to
talk to NZ National Human Rights Institution (NHRI) representatives
(Children's Commissioner and Human Rights Commission), and share newly
received additional evidence (thank you!) of the
NZ High Cost Treatment Pool to this day financing partial clitoris
amputations on children with "Congenital Adrenal Hyperplasia (CAH)" oversees,
which confirms the evidence presented in our
Thematic NGO Report. I was informed they had also seen the evidence proving
the flat-out gov denial (see transcript above) was just that, a denial, and
that they would too raise this with the Committee. So we'll have to see if
there are any follow-up questions today. But even if there aren't, we remain
confident, as it's business as usual for govs to issue full denials in treaty
body reviews (often with some pinkwashing on top) – to which the Committee
usually answers with yet another reprimand ...

10:50h: CRC expert Jorge Cardona Lorens asks
if involuntary sterilisation of children with disabilities is
still taking place. Unofficial Transcription:

« Is there still sterilisation of children with
disabilities with the parental consent? »

10:54h: NZ Delegation member Dr Patrick
Tuohy (Paediatrician, Chief Adviser, Ministry of Health)
admits to cases of NZ parents going oversees to have children with
disabilities sterilised, and also in NZ"after any other means had
been found ineffective" (!!) Unofficial
Transcription:

« With respect to sterilization of children, you are
correct, the law in NZ still permits children to be sterilized with consent of
their parents, if they are unable to make an informed decision, but not on the
basis of age, on the basis of intellectual disability.

However, I want to point out that there is work being undertaken as part
of our revised disability strategy which is a section where we’re working with
disability groups within NZ to identify a process for ensuring bodily integrity
of children and adults with disability, to ensure that that is addressed. And I
would also point out that even though there are reports of this occurring on
occasions, with the consent of the parents and there is one recent case of
about seven, eight years ago, which the parents went overseas
for the initiation of the program as it was not able to be done in NZ.
Most clinicians were undertaking sterilization for example of a young
woman would use that as a last resort, when every other method of managing
instruction [?] or some other issue had been tried and found to be ineffective.
»

« I would like to go back to
violence, and particularly on children, intersex
children. You have stated yesterday that there was no surgery operated
on intersex children since 2006 in NZ, but I would like you to inform the
Committee, if NZ government provided funding for genital normalization
surgeries outside of NZ on intersex children of course, and were the funds for
these surgeries come from special High-Cost Treatment Pool? If so, can you give
us a number of these surgeries conducted outside? »

16:24h: NZ Delegation member Dr Patrick Tuohy
(Paediatrician, Chief Adviser, Ministry of Health) (non-)answers the
follow-up question on intersex children, basically repeating and embellishing
his earlier flat-out denial: Claims IGM to be a thing of the
past, with ealier shortcomings "effectively addressed" in the
meantime and today the surgeons and endocrinologists would treat intersex
children "non-operatively" unless absolutely medically
necessary, claims there was no record immediately available for treatments
oversees, again "misunderstanding" the actual question by consistently
referring to "gender assignment surgeries" – how typical is
that?! Unofficial Transcription:

Anne Tolley (Head of Delegation and Minister for Social
Development): « I’m going to ask Dr Pat Tuohy to just talk
about intersex children and the funding, the questions around funding for
outside of NZ, where the funds come from and the number.
»

Dr Patrick Tuohy (Paediatrician, Chief Adviser, Ministry of
Health, Wellington, NZ): « [Undiscernible] Minister, and I
believe this was your question. NZ is of course aware of that
historically there had been cases of early gender assignment,
as was the current medical approach some decades ago.

But health officials are not aware of any incidence of this in recent
years. As the Committee will be aware there has been a significant change in
medical best practice consensus in this area over the last five to ten years in
many countries including New Zealand. The current international and New Zealand
consensus is that all none non-essential treatment in children
with disorders of sexual development, which is the preferred name rather than
intersex, should wait until the person with the DSD condition
is older and can consent. When this cannot be the case, when an urgent surgery
might need to be required, decisions about surgery made by the parents and
extended family in consultation with medical doctors involved. Now, New Zealand
does not have a legal or regular [undiscernible] framework in place for gender
assignment surgery for children with DSD, as we believe that our results
demonstrate that we have effectively addressed this issue through the processes
that we have in place.

New Zealand has a multidisciplinary network of surgeons and
endocrinologists who discuss all cases in which there may be concerns
about a child’s gender, in accordance with international best practice the
default practice is non-operative support that [undiscernible]
network of endocrinologists and surgeons are confident that no medical
practitioners in NZ are working in isolation.

They are aware of and support the evidence based
guidelines described in the internationally supported clinical
guidelines for the management of disorders of sex development in
childhood. As these specialists are also the referring and ongoing clinicians
involved in the care of children and maintain this responsibility in respect
[undiscernible] to a centre within New Zealand or oversees.

Gender reassignment surgery for adults is covered by
the provisions of the High-Cost Treatment Pool which is administered by the
Ministry of health. Gender reassignment medical treatment, predominantly
hormone treatment, is available in New Zealand through the district health
boards, and if surgery is [undiscernible] in this context any state's support
through the High-Cost Treatment Poool is limited to people over the age
of 18 years who are actively seeking the surgery.

I’m not aware whether any children or adolescents under
the age of 18 have received funding for the High-Cost Treatment Pool
for genital surgery oversees related to DSD. It may be possible to
determine this, but review of individual files may be
required, and that could take some time. So while we
could [undiscernible] team to get that back to you I suspect that going through
the files would take more than a few days – over a weekend. OK.
»

After the Session: I spoke briefly to Dr Patrick Tuohy,
making sure he got a copy of our
thematic NGO report (which he said he had studied in advance), though it
was somewhat of a challenge getting a word or two in inbetween. Dr
Tuohy's standpoint was that there wasn't sufficient
proof of IGM practices still taking place, as "hypospadias repair"
from his point of view wouldn't count, and the sources given for NZ children
operated on in Australia (from 2013 and 2009) were too old to contradict his
claim that surgery had stopped (latest in 2006). He further argued he had
studied the framework of harmful practices and found that it was not
applicable to IGM practices anyway, as from his viewpoint intersex
surgeries wouldn't fit the definitions stipulated therein (apparently despite
stating he had studied our NGO report he seemed unaware that over the last 2
years, CRC has so far found IGM practices to constitute a harmful practice 6
times).

« 1. Has the High Cost Treatment Pool in the Ministry of Health
previously funded genital surgery for intersex infants, provided at the Royal
Children’s Hospital in Melbourne?

We have previously stated that there has been no surgery related to
gender assignment in New Zealand since 2006. This statement was based on what
now appears to be an incomplete review of hospital coding records. The Ministry
of Health has undertaken a more detailed search and we would like to draw the
committee’s attention to the following updated information on this
issue.

Until 2007, the High Cost Treatment Pool in the Ministry of Health
funded genital surgery for intersex infants, provided at the Royal Children's
Hospital in Melbourne.. Between 1999 and 2007, the High Cost Treatment Pool
funded treatment for 15 girls with congenital adrenal hyperplasia, for genital
feminisation. The Royal Children’s Hospital then stopped providing this
treatment.

More recently, two paediatric surgeons have begun to undertake these
operations in New Zealand. These operations continue at about the same rate as
before. The incidence of these cases in New Zealand is estimated to be around
one or two a year. »

Intersex Genital Mutilations • 17 Most Common
Forms
HumanRights Violations Of Children With Variations Of Sex
AnatomyIGM – Historical
Overview•What is
Intersex?•How Common are
IGMs?>>>
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"Human Rights For Hermaphrodites Too!"

StopIGM.org is an international human rights NGO of survivors and allies fighting Intersex Genital Mutilations (IGM) in children's clinics, and for the right to physical integrity and self determination for all children born with 'atypical genitalia', or Variations of Sex Anatomy. IGM Practices are a serious human rights violation and MUST STOP.